Reversal Agents - Glycopyrrolate Flashcards
What is the recommended dose range for Glycopyrrolate when used with Neostigmine? (Select all that apply)
a) 5-10 mcg/kg
b) 10-20 mcg/kg
c) 15 mcg/kg
d) 0.4 mg/kg
b) 10-20 mcg/kg
c) 15 mcg/kg
Dose Range: 10-20 (15) mcg/kg (0.2 mg/mL) or 0.2 mg for each 1mg neostigmine
-you will be dosing glycopyrrolate first before neostigmine, give in increments of 0.2 mg so you dont cause too much tachycardia.
TxWes Reference:
Glycopyrrolate 0.2 mg per mg of Neostigmine
Castillo NMBD Reversal:
Glycopyrrolate: 7 to 15 µg/kg (1 mg maximum)
What is the recommended concentration of Glycopyrrolate for preparation?
a) 0.1 mg/mL
b) 0.2 mg/mL
c) 1 mg/mL
d) 2 mg/mL
b) 0.2 mg/mL
0.2 mg for each 1mg neostigmine
How should Glycopyrrolate be administered in relation to Neostigmine to minimize adverse effects? (Select 2)
a) Administer Glycopyrrolate after Neostigmine.
b) Administer Glycopyrrolate before Neostigmine.
c) Give Glycopyrrolate in increments of 0.2 mg to avoid excessive tachycardia.
d) Administer Glycopyrrolate as a single large dose to reduce the need for multiple injections.
b) Administer Glycopyrrolate before Neostigmine
c) Give Glycopyrrolate in increments of 0.2 mg to avoid excessive tachycardia
What is the concentration of Glycopyrrolate typically used for administration? (Select all that apply)
a) 0.1 mg/mL
b) 0.2 mg/mL
c) 1 mg/mL
d) 2 mg/mL
b) 0.2 mg/mL
What is the mechanism of action of Glycopyrrolate? (Select 3)
a) It is a quaternary amine that does not pass the blood-brain barrier (BBB).
b) It blocks muscarinic acetylcholine receptors (mACh Rs) at smooth muscle, glands, and the heart.
c) It blocks post-ganglionic sympathetic (SNS) receptors.
d) It inhibits post-ganglionic parasympathetic (PSNS) fibers.
a) It is a quaternary amine that does not pass the blood-brain barrier (BBB),
b) It blocks muscarinic acetylcholine receptors (mACh Rs) at smooth muscle, glands, and the heart,
d) It inhibits post-ganglionic parasympathetic (PSNS) fibers
What is the half-life of Glycopyrrolate?
a) 1 hour
b) 2 hours
c) 4 hours
d) 6 hours
b) 2 hours
What is the onset time of Glycopyrrolate when administered?
a) 1-2 minutes
b) 2-3 minutes
c) 5-10 minutes
d) 30 minutes
b) 2-3 minutes
Which of the following are side effects of Glycopyrrolate? (Select 3)
a) Decreased bronchial secretions
b) Increased gastrointestinal secretions
c) Increased intraocular pressure
d) Pupil dilation
a) Decreased bronchial secretions,
c) Increased intraocular pressure,
d) Pupil dilation
How is Glycopyrrolate eliminated from the body? (Select 2)
a) Excreted unchanged in urine
b) Metabolized in the liver
c) Excreted unchanged in bile
d) Excreted in feces
c) Excreted unchanged in bile
d) Excreted in feces
Elimination: metabolic rate is unknown; excretion unchanged in bile, feces, and small amount in urine
In which conditions is Glycopyrrolate contraindicated? (Select 3)
a) Open-angle glaucoma
b) Closed-angle glaucoma
c) Autonomic neuropathy
d) Unstable cardiovascular status
b) Closed-angle glaucoma
c) Autonomic neuropathy
d) Unstable cardiovascular status
Why is Glycopyrrolate administered in patients with cardiac disease? (Select 2)
a) To enhance sympathetic nervous system activity
b) To counteract the vagal response that could lead to bradycardia
c) To treat hypertension
d) To mitigate the effects of parasympathetic stimulation
b) To counteract the vagal response that could lead to bradycardia,
d) To mitigate the effects of parasympathetic stimulation
What are common effects of Glycopyrrolate? (Select 3)
a) Tachycardia
b) Bronchodilation
c) Antisialogogue (reduction in saliva)
d) Hypotension
a) Tachycardia,
b) Bronchodilation,
c) Antisialogogue (reduction in saliva)
Precautions:
Tachycardia ++
Bronchodilation ++
Antisialogogue +++
does not block all s/e of reversal drugs (nausea still issue)
What effect does Glycopyrrolate have on gastrointestinal secretions?
a) Decreases gastrointestinal secretions
b) Increases gastrointestinal secretions
c) Has no effect on gastrointestinal secretions
d) Reduces nausea
a) Decreases gastrointestinal secretions
What is the effect of Glycopyrrolate on the central nervous system? (Select 2)
a) It has a sedative effect
b) It has no sedative effect
c) It can cause emergence delirium
d) It does not cause emergence delirium due to its amine structure
b) It has no sedative effect,
d) It does not cause emergence delirium due to its amine structure
